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Court Ruling May Affect Some Hospitals’ 340B Eligibility

Decision is the latest twist in dispute over how to calculate disproportionate share percentage
 

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December 19, 2012—A recent ruling in a prolonged legal battle over how to count Medicare Part C managed care patient days toward safety-net hospitals’ disproportionate share (DSH) percentages could affect some hospitals’ participation in the 340B drug discount program.

In its Nov. 15 decision in Allina Health Services v. Sebelius, the U.S. District Court for the District of Columbia held that the Centers for Medicare and Medicaid Services (CMS) did not follow proper administrative procedures when it issued and then implemented a 2004 rule requiring Medicare Part C days to be included in the Supplemental Security Income (SSI)/Medicare fraction of a hospital’s DSH percentage. 


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